FORM NO.

DIR-3 Application for allotment of Director

Identification Number
[Pursuant to section 153 of The Companies Act,
2013 & Rule 9(1) of the Companies (Appointment
and Qualification of Directors) Rules, 2014 & Rule
10 of Limited Liability Partnership Rules, 2009]

- All fields marked in * are to be mandatorily filled.

- Income-tax Permanent Account Name (Income-tax PAN) is mandatory in case of Indian nationals and in
such case applicant details should be as per Income-tax PAN. In case the details as per Income-tax PAN are
incorrect, applicant is advised to first correct the details in Income-tax PAN. Refer instruction kit for details.
- In case of foreign nationals, Passport number is mandatory.

1. *Applicant's name (Enter full name and do not use abbreviations) Photograph

(a) First name

(b) Last name

(c) Middle name

2. *Father's name (Even married women must give father's name)

(a) First name

(b) Last name (Attach a latest passport size

photograph by clicking on
(c) Middle name above box)

3. *Whether a citizen of India Yes No

Remove Photograph

4. Nationality

5. *Whether resident in India Yes No

6. (a) *Occupation Type Self Employed Professional Homemaker Student Serviceman

Area Of Occupation

If 'others' selected, please specify

(b) *Educational qualification

7. *Date of birth (DD/MM/YYYY)

8. *Gender Male Female Transgender

9. Place of birth

10. Income-tax permanent account number Verify Income-tax PAN details

11. Voter's identity card number

12. Passport number

13. Driving license number

14. Aadhaar Number

15. Permanent residential address

*Line I

Line II

*City

*State *Pin code

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 *ISO country code
Country

*Phone Mobile Fax

*e-mail ID

16. *Whether present residential address is same as permanent residential address Yes No

17. Present residential address

Line I

Line II

City

State Pin code

ISO country code

Country

Phone Fax
List of attachments
Attachments

1. * Proof of identity of applicant Attach

2. * Proof of residence of applicant Attach

3. * Copy of verification by the applicant as per Attach

Form No. DIR-4
4. Optional attachment(s) - if any Attach

Remove attachment
*To be Digitally signed by Applicant

Modify Check Form Prescrutiny Submit

Note: Attention is drawn to provisions of Section 448 and 449 which provide for punishment

for false statement / certificate and punishment for false evidence respectively.

For office use only: Affix filing details

eForm Service request number (SRN) eForm filing date (DD/MM/YYYY)

Digital signature of the authorising officer

This e-Form is hereby approved

Confirm Submission
This e-Form is hereby rejected

Date of signing (DD/MM/YYYY)

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